Decreased VEGF levels detected in infants treated with anti-VEGF for active ROP

Elevated serum levels of bevacizumab and reduced serum levels of VEGF were identified in infants with retinopathy of prematurity who underwent intravitreal bevacizumab injections, a study found.
“The results suggest that bevacizumab escapes from the vitreous into systemic circulation and could suppress the VEGF concentration in infants with ROP after intravitreal bevacizumab,” the study authors said. “Although no systemic adverse events were observed in our patients, continued extensive evaluation of infants is warranted for possible effects after intravitreal bevacizumab in ROP patients.”
The study included 11 infants with highly vascular-active ROP who received unilateral or bilateral 0.25 mg or 0.5 mg intravitreal injections of Avastin (bevacizumab, Genentech) and underwent 23-gauge pars plicata vitrectomy without a cannula. Mean gestational age was 25 weeks. Surgery was performed within 1 week after the injection when deemed necessary.
Blood samples were collected before injection and 1 day, 1 week and 2 weeks after injection. Enzyme-linked immunosorbent assays were used to measure serum concentrations of bevacizumab and VEGF.
Study results showed a significant negative correlation between the serum concentration of bevacizumab and VEGF in infants who received 0.25 mg or 0.5 mg injections of bevacizumab (P = .0125).
Serum levels of bevacizumab were markedly elevated 1 week after a total of 0.5 mg or 1 mg injections. The highest serum level of bevacizumab was identified 2 weeks after a total of 0.5 mg injections, the authors said.